Asia Maurich Novelli, Sukhwinder Shergill,  Andreia Sofia Teixeira

JMIR Ment Health 2026;13:e99354

People increasingly turn to conversational AI for companionship, emotional support, and well-being, using both purpose-built companion apps, such as Replika and Character.AI, and general-purpose assistants, such as ChatGPT and Claude. While some evidence suggests potential benefits, including short-term reductions in loneliness and mood improvement, several adverse outcomes have been reported in both clinical and nonclinical populations, including emotional dependence, exacerbation of symptoms, and self-harm. The fluent and apparently empathic responses from these models lead users to engage with them not only as tools but also as if they were social entities. This framing is conceptually misleading and may pose risks across different user profiles, particularly for vulnerable individuals. Drawing on research in AI, psychiatry, psychology, and network science, we highlight mechanisms through which emotional reliance develops and the boundary between tool and companion erodes. Design choices that evoke personality and warmth encourage users to anthropomorphize these systems. Simulated empathy, generated through probabilistic language patterns rather than genuine emotional experience, creates a structurally asymmetric interaction, in which the user discloses and the system responds, but without reciprocity, vulnerability, or accountability. Overvalidation and sycophancy can reinforce maladaptive cognitions, delusional ideation, and distorted perceptions of reality, as they tend to reinforce people’s beliefs, even at the expense of the accuracy of models’ responses. These mechanisms are not incidental: they emerge from alignment procedures that reward responses perceived as warm and empathic. The result is a self-reinforcing feedback loop between the model and the user that may amplify maladaptive beliefs, delusional ideation, and emotional distress, even in those who engage for largely functional purposes. Understanding these dynamics requires an examination of both what these agents can do—considering their technical limitations and implementations—and what humans believe they can do, including social and psychological impacts. We argue that conversational AI should be treated primarily as a tool supporting human systems rather than as a substitute for human relationships. Perhaps more importantly, reviewing the current hype surrounding AI interactions can help reformulate a paradigm that contributes to human well-being and societal value, while minimizing misconceptions, maladaptive interactions, or social disintegration.People increasingly turn to conversational AI for companionship, emotional support, and well-being, using both purpose-built companion apps, such as Replika and Character.AI, and general-purpose assistants, such as ChatGPT and Claude. While some evidence suggests potential benefits, including short-term reductions in loneliness and mood improvement, several adverse outcomes have been reported in both clinical and nonclinical populations, including emotional dependence, exacerbation of symptoms, and self-harm. The fluent and apparently empathic responses from these models lead users to engage with them not only as tools but also as if they were social entities. This framing is conceptually misleading and may pose risks across different user profiles, particularly for vulnerable individuals. Drawing on research in AI, psychiatry, psychology, and network science, we highlight mechanisms through which emotional reliance develops and the boundary between tool and companion erodes. Design choices that evoke personality and warmth encourage users to anthropomorphize these systems. Simulated empathy, generated through probabilistic language patterns rather than genuine emotional experience, creates a structurally asymmetric interaction, in which the user discloses and the system responds, but without reciprocity, vulnerability, or accountability. Overvalidation and sycophancy can reinforce maladaptive cognitions, delusional ideation, and distorted perceptions of reality, as they tend to reinforce people’s beliefs, even at the expense of the accuracy of models’ responses. These mechanisms are not incidental: they emerge from alignment procedures that reward responses perceived as warm and empathic. The result is a self-reinforcing feedback loop between the model and the user that may amplify maladaptive beliefs, delusional ideation, and emotional distress, even in those who engage for largely functional purposes. Understanding these dynamics requires an examination of both what these agents can do—considering their technical limitations and implementations—and what humans believe they can do, including social and psychological impacts. We argue that conversational AI should be treated primarily as a tool supporting human systems rather than as a substitute for human relationships. Perhaps more importantly, reviewing the current hype surrounding AI interactions can help reformulate a paradigm that contributes to human well-being and societal value, while minimizing misconceptions, maladaptive interactions, or social disintegration.

Read the full article at: mental.jmir.org

Miao Zeng, Roberto Murcio, Camilo Vargas-Ruiz, Elsa Arcaute

Achieving universal health coverage, as set out in Sustainable Development Goal 3.8, requires closing persistent geographic and socioeconomic gaps in healthcare access, especially in under-resourced settings across Africa. Healthcare-access inequality is shaped not only by poor local access, but also by limited connectivity to city- and regional-level services and opportunities. Conventional accessibility analysis can identify where poor access occurs, but not whether poorly served places form structurally disconnected pockets across scales. This paper therefore builds on and extends the percolation divergence tree framework to develop a connectivity-based multiscale approach for examining healthcare-access inequality in Ghana. It combines street-level accessibility mapping with the hierarchical structure of the road network to identify the scales at which inequality coincides with connectivity breaks. The results first show substantial inequality: around one quarter of the population lives more than 5 km from the nearest healthcare facility. Multiscale analysis further reveals distinct structural forms of poor access. In relatively well-connected, monocentric regions, local poor-access pockets emerge around metropolitan fringes despite overall regional advantage. In less well-connected, polycentric regions, poor access extends across larger subsystems, with local pockets nested within broader poorly served areas. These findings show that healthcare-access inequality reflects both local conditions and the hierarchical connectivity of the wider spatial system, which may also constrain marginalised communities’ access to other key resources and services. The framework can inform targeted local interventions and policy coordination across local and regional scales.

Read the full article at: arxiv.org

Pablo Villegas, Sandro Meloni

Group interactions are widespread, and higher-order extensions of familiar models display collective phenomena absent from their pairwise baselines, which are routinely offered as evidence of a distinct higher-order physics. We ask whether that claim survives the test that gives new a precise meaning in statistical physics: that of universality. Revisiting canonical higher-order models, we argue that what classifies collective behavior are the infrared ingredients that survive at long scales. Arity is not a universality label. Beyond universality, we examine two further questions: whether higher-order structure is a fact about the system or a choice of description, and what data can and cannot tell us about interaction order. Higher-order descriptions remain indispensable when they expose the organizing structure, provide a better mechanistic language, or improve prediction. We close with what should be measured before new phenomena can be claimed, and where higher-order structure already earns its place.

Read the full article at: arxiv.org